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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:

33卷

期数:

2020年08期

页码:

105-107

栏目:

临床研究

出版日期:

2020-04-15

文章信息/Info

Title:

Comparison of Channel-assisted Percutaneous Pedicle Screw Internal Fixation with Traditional Percutaneous Internal Fixation for Thoracolumbar Fractures

文章编号:

1006-1959（2020）08-0105-03

作者:

陈 啸; 张文志; 傅 扬

（安徽医科大学附属省立医院脊柱外科，安徽 合肥 230001）

Author(s):

CHEN Xiao; ZHANG Wen-zhi; FU Yang

(Spine Surgery,Provincial Hospital Affiliated to Anhui Medical University,Hefei 230001,Anhui,China)

关键词:

通道; 经皮椎弓根螺钉; 胸腰椎骨折; 辐射; 微创

Keywords:

Channel; Percutaneous pedicle screw; Thoracolumbar fracture; Radiation; Minimally invasive

分类号:

R511.5

DOI:

10.3969/j.issn.1006-1959.2020.08.032

文献标志码:

A

摘要:

目的 比较通道辅助下经皮椎弓根螺钉内固定与传统经皮内固定治疗胸腰椎骨折的疗效。方法 回顾性分析2017年1月~2019年4月我院收治的40例胸腰椎骨折患者临床资料，按照随机数字表法分为观察组与对照组，每组20例。对照组采用无通道辅助传统经皮内固定术治疗，观察组采用通道辅助经皮椎弓根螺钉内固定术治疗。比较两组手术时间、术中出血量、术中透视时间，手术前后VAS评分以及术前、术后正侧位X线片上矢状位Cobb角、椎体高度改变。结果 两组术中出血量比较，差异无统计学意义（P＞0.05）；观察组手术时间、术中透视时间均低于对照组[（55.30±6.20）min vs （60.70±5.60）min、（6.70±2.10）s vs （9.30±1.80）s]，差异有统计学意义（P＜0.05）；两组术前VAS评分比较，差异无统计学意义（P＞0.05）；术后3 天两组VAS评分均低于术前，差异有统计学意义（P＜0.05），观察组低于对照组，但差异无统计学意义（P＞0.05）；两组术前Cobb角、椎体高度比较，差异无统计学意义（P＞0.05）；术后3 天两组Cobb角低于术前，椎体高度高于术前，差异有统计学意义（P＜0.05），术后3 天两组Cobb角、椎体高度比较，差异无统计学意义（P＞0.05）。结论 通道辅助下经皮椎弓根螺钉内固定术治疗胸腰椎骨折与传统经皮置钉相比，可缩短手术时间、减少辐射暴露，且不增加患者疼痛，是一种安全有效的术式。

Abstract:

Objective To compare the efficacy of channel-assisted percutaneous pedicle screw internal fixation with traditional percutaneous internal fixation for thoracolumbar fractures.Methods The clinical data of 40 patients with thoracolumbar fractures admitted to our hospital from January 2017 to April 2019 were retrospectively analyzed.They were divided into observation group and control group according to random number table method,with 20 cases in each group.The control group was treated with no channel-assisted traditional percutaneous internal fixation,and the observation group was treated with channel-assisted percutaneous pedicle screw internal fixation.The operation time,intraoperative blood loss,intraoperative fluoroscopy time,VAS score before and after the operation,and the sagittal Cobb angle and vertebral body height on the X-ray film before and after the operation were compared between the two groups.Results There was no statistically significant difference in intraoperative bleeding between the two groups(P＞0.05);the operation time and intraoperative fluoroscopy time in the observation group were lower than those in the control group [(55.30±6.20)min vs (60.70±5.60)min,(6.70±2.10)s vs (9.30±1.80)s],the difference was statistically significant(P＜0.05);the preoperative VAS score comparison between the two groups was not statistically significant(P＞0.05);the VAS of the two groups was 3 d after surgery the scores were lower than before the operation,the difference was statistically significant(P＜0.05),the observation group was lower than the control group,but the difference was not statistically significant(P＞0.05);There was no significant difference in Cobb angle and vertebral body height between the two groups before operation(P＞0.05);3 d after operation,the Cobb angle in the two groups was lower than before operation,and the vertebral body height was higher than before operation,the difference was statistically significant(P＜0.05).There was no significant difference in Cobb angle and vertebral body height between the two groups 3 d after operation(P＞0.05).Conclusion Channel-assisted percutaneous pedicle screw internal fixation for thoracolumbar vertebral fractures can shorten the operation time,reduce radiation exposure,and does not increase patient pain compared with traditional percutaneous nail placement.It is a safe and effective procedure.

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更新日期/Last Update: 2020-04-15